Fiber scaffolds for use in esophageal prostheses

ABSTRACT

The development and construction of implantable artificial organs, and a process for manufacturing three-dimensional polymer microscale and nanoscale structures for use as scaffolds in the growth of biological structures such as hollow organs, luminal structures, or other structures within the body are disclosed.

BACKGROUND OF THE INVENTION

The esophagus is an organ within the neck that permits travel of food and saliva from the mouth to the stomach through peristalsis. It has a generally tubular shape consisting of multiple layers ranging from a mucosa layer on the lumen consisting primarily of epithelial cells to a muscular adventitia consisting primarily of smooth muscle cells, striated muscle cells and fibroblasts. The inner layer of muscle is oriented in a circumferential direction while the outer layer of muscle is oriented in a longitudinal direction (see FIG. 1). When at rest, the esophagus is nearly collapsed, but can expand to roughly 3 cm in diameter upon swallowing.

Peristalsis involves involuntary movements of the longitudinal and circular muscles, primarily in the digestive tract but occasionally in other hollow tubes of the body, that occur in progressive wavelike contractions. Peristaltic waves occur in the esophagus, stomach, and intestines. The waves can be short, local reflexes or long, continuous contractions that travel the whole length of the organ, depending upon their location and what initiates their action. In the esophagus, peristaltic waves begin at the upper portion of the tube and travel the whole length, pushing food ahead of the wave into the stomach. Particles of food left behind in the esophagus initiate secondary peristaltic waves that remove leftover substances. One wave travels the full length of the tube in about nine seconds. Peristaltic waves start as weak contractions at the beginning of the stomach and progressively become stronger as they near the distal stomach regions. The waves help to mix the stomach contents and propel food to the small intestine. Usually, two to three waves are present at one time in different regions of the stomach, and about three waves occur each minute.

In the large intestine (or colon), the peristaltic wave, or mass movement, is continuous and progressive; it advances steadily toward the anal end of the tract, pushing waste material in front of the wave. When these movements are vigorous enough to pass fecal masses into the rectum, they are followed by the desire to defecate. If feces are passed to the rectum and not evacuated from the body, they are returned to the last segment of the colon for longer storage by reverse peristaltic waves. Peristaltic waves are particularly important in helping to remove gas from the large intestine and in controlling bacterial growth by mechanically acting as a cleansing agent that dislodges and removes potential colonies of bacteria.

Partial loss or complete loss of peristalsis due to the loss of the esophagus, small intestine and/or large intestine due to cancer or other diseases can have a catastrophic, if not fatal, effect on an animal. A number of in vivo prostheses for luminal structures such as the esophagus are known. Typically these prostheses are formed by donor structures from cadavers or are manmade structures. However, these existing structures are subject to failure due to anastomotic stenosis, luminal stenosis, infection, dislocation, and migration, among other causes. Therefore, there is an ongoing need for artificial or prosthetic versions of organs such as the esophagus and intestinal tract that will provide the patient, human or otherwise, with a functioning replacement for the lost organ.

DESCRIPTION OF THE DRAWINGS

The file of this patent contains at least one photograph or drawing executed in color. Copies of this patent with color drawing(s) or photograph(s) will be provided to the Patent and Trademark Office upon request and payment of necessary fee

The accompanying drawings, which are incorporated into and form a part of the specification, schematically illustrate one or more exemplary embodiments of the invention and, together with the general description given above and detailed description given below, serve to explain the principles of the invention, and wherein:

FIG. 1 a is an illustration of the anatomy of the esophagus from Frank H. Netter and FIG. 1 b is an illustration of a portion of the small intestine;

FIG. 2 is a photograph of an exemplary fiber deposition system, in accordance with the present invention;

FIGS. 3A, 3B, 3C and 3D provide several photographs of examples of relatively small and large diameter tubes and irregular shapes derived from electrospun fiber made with the process of the present invention;

FIGS. 4A, 4B, 4C and 4D provide a number of photographs illustrating the control of cell orientation and differentiation based on discrete fiber alignment;

FIGS. 5A and 5B provide photographs of a 200 nm diameter fiber (on the left) with pore sizes of a few microns and a 20 um diameter fiber (on the right) with pore sizes of around 50 um; and

FIG. 6 is an SEM image of composite fiber scaffold that includes both oriented fibers and random fibers.

DESCRIPTION OF THE INVENTION

Exemplary embodiments of the present invention are now described with reference to the Figures. Although the following detailed description contains many specifics for purposes of illustration, a person of ordinary skill in the art will appreciate that many variations and alterations to the following details are within the scope of the invention. Accordingly, the following embodiments of the invention are set forth without any loss of generality to, and without imposing limitations upon, the claimed invention.

The present invention relates generally to the development and construction of implantable artificial organs, and more specifically to a process for manufacturing three-dimensional polymer microscale and nanoscale structures for use as scaffolds in the growth of biological structures such as hollow organs, luminal structures, or other structures within the body, particularly the esophagus (see FIG. 1A) and/or the small intestine (see FIG. 1B), large intestine, duodenum, and jejunum. Exemplary versions of the manufacturing process of this invention include preparing a preform that is based on an actual organ; electro spinning one or more layers of nanoscale (less than 1000 nanometers) or microscale (less than 50 microns) polymer fibers on the preform to form a nanofiber based scaffold. The fibers are typically formed by electrospinning by extruding a polymer solution from a fiberization tip; creating an electronic field proximate to the fiberization tip; and positioning a ground or opposite polarity within the preform. The preform may be rotated to align the fibers on the preform or a second ground or polarity may be placed in the preform and rapidly switching the electric field to align the fibers. The microscale and nanoscale polymer fibers may be randomly aligned or maybe substantially parallel or both (see FIG. 6). These nanofiber structures may be seeded with one or more types of biological cells prior to implantation in the body to increase the rate of tissue growth into the scaffold. The scaffold may include autologous or allogenic cells such as cord blood cells, embryonic stem cells, induced pluripotent cells, mesenchymal cells, placental cells, bone marrow derived cells, hematopoietic cell, epithelial cells, endothelial cells, fibroblasts, chondrocytes or combinations thereof.

Choosing a material that accurately mimics the mechanical properties of the native esophagus (or other organ) can promote proper stem cell differentiation and facilitate normal esophageal function such as peristalsis. Materials may be non-resorbable for permanent implantation or may be designed to slowly degrade while the host body rebuilds the native tissue until the implanted prosthesis is completely resorbed. Permanent polymers may include polyurethane, polycarbonate, polyester terephthalate and degradable materials may include polycaprolactone, polylactic acid, polyglycolic acid, gelatin, collagen, or fibronectin. The fibers may be electrospun onto a preform with the desired prosthesis shape (see FIG. 2). FIG. 2 is a photograph of an exemplary setup of a 5 mm diameter rod with electrospun fiber being deposited onto the surface. The exemplary mandrel is coated with Teflon to facilitate removal of the scaffold after deposition or a slight taper(≈1°) can be manufactured into the mandrel. Nearly any size or shape can be produced from the electrospun fibers by using a pre-shaped form and deposition method as shown in FIGS. 3A-3D.

Closely mimicking the structural aspects of the native esophagus (or other organ) is important with regard to replicating the function of the native esophagus. By controlling the orientation of the fibers and assembling a composite structure of different materials and/or different fiber orientations it is possible to control and direct cell orientation and differentiation (see FIGS. 4A-4D). Fiber orientation can be altered in each layer of a composite or sandwich scaffold in addition to the material and porosity to most closely mimic the native tissue. A properly constructed scaffold will permit substantially complete cellular penetration and uniform seeding for proper function and prevention of necrotic areas developing. If the fiber packing is too dense, then cells may not be able to penetrate or migrate from the exposed surfaces into the inner portions of the scaffold. However, if the fiber packing is not close enough, then the attached cells may not be able to properly fill the voids, communicate and signal each other and a complete tissue or organ may not be developed. Controlling fiber diameter can be used to change scaffold porosity as the porosity scales with fiber diameter (see FIGS. 5A-5B). Alternatively, blends of different polymers may be electrospun together and one polymer preferentially dissolved to increase scaffold porosity. The properties of the fibers can be controlled to optimize the fiber diameter, the fiber spacing or porosity, the morphology of each fiber such as the porosity of the fibers or the aspect ratio, varying the shape from round to ribbon-like. The precursor solution described below may be controlled to optimize the modulus or other mechanical properties of each fiber, the fiber composition, the degradation rate (from rapidly biosoluable to biopersitent. The fibers may also be formed as drug eluting fibers, anti-bacterial fibers or the fibers may be conductive fibers, radio opaque fibers to aid in positioning or locating the fibers in an x-ray, CT or other scan.

The effects of mechanical strain on electrospun polymer scaffolds has been described in the literature (see, Microstructure-Property Relationships in a Tissue Engineering Scaffold, Johnson et al., Journal of Applied Polymer Science, Vol. 104, 2919-2927 (2007) and Quantitative Analysis of Complex Glioma Cell Migration on Electrospun Polycaprolcatone Using Time-Lapse Microscopy, Johnson et al., Tissue Engineering; Part C, Volume 15, Number 4, 531-540 (2009), which are incorporated by reference herein, in their entirety, for all purposes). Strains as low as 10% appear to rearrange and align the fibers in the direction of loading. This alignment increases with the applied strain until over 60% of the fibers are aligned within ±10% of the direction of applied stress. If cells are present during fiber rearrangement in vivo or in vitro, they could conceivably be affected by these changes depending on the overall rate of strain. Fiber alignment is retained following a single cycle of extension and release. This has significant biological implications for a broad array of future tissue-engineering operations. As cells move across such a substrate, biased motion is likely as locomotion is based on forming and then dissolving a series of focal adhesions. Formation of these adhesions along the fiber direction may be easier than those perpendicular to that direction although this will be partially controlled by the spacing between the fibers. This has longer-term consequences for the eventual control of the architecture of tissues that develop upon such substrates.

Cellular mobility parallel to the fiber direction means that one could conceivably control and direct cell proliferation and migration by prestraining scaffolds to align the fibers in certain directions. This could result in tailored structures with highly aligned fibers and, as a result, highly aligned cells. Of additional importance is the fact that many envisioned applications of tissue-engineering scaffolds will involve the use of cyclic stresses designed to achieve specific architectures in the biological component of the developing tissue. If the scaffold experiences continuing hysteresis in which orientation increases versus the number of cycles the efficiency of the overall process will be greatly enhanced. For blood vessels, as an example, the application of cyclic pressures will produce preferential stresses that could cause significant alignment of the fibers in the circumferential direction. This could cause cellular alignment in the circumferential direction, potentially creating a more biomimetic arrangement.

Within the context of this invention, electrospinning is driven by the application of a high voltage, typically between 0 and 30 kV, to a droplet of a polymer solution or melt at a flow rate between 0 and 50 ml/h to create a condition of charge separation between two electrodes and within the polymer solution to produce a polymer jet. A typical polymer solution would consist of a polymer such as polycaprolactone, polystyrene, or polyethersulfone and a solvent such as 1,1,1,3,3,3-Hexafluoro-2-propanol, N,N-Dimethylformamide, Acetone, or Tetrahydrofuran in a concentration range of 1-50 wt %. As the jet of polymer solution travels toward the electrode it is elongated into small diameter fibers typically in the range of 0.1-30 μm.

In preparing an exemplary scaffold, a polymer nanofiber precursor solution is prepared by dissolving 2-30 wt % polyethylene terephthalate (PET) (Indorama Ventures) in a mixture of 1,1,1,3,3,3-hexafluoroisopropanol and trifluoroacetic acid and the solution is heated to 60° C. followed by continuous stirring to dissolve the PET. The solution may be cooled to room temperature and the solution placed in a syringe with a blunt tip needle. The nanofibers are formed by electrospinning using a high voltage DC power supply set to 1 kV-40 kV positive or negative polarity, a 5-30 cm tip-to-substrate distance, and a 1 μl/hr to 100 mL/hr flow rate. It is possible to use a needle array of up to 1,000's of needles to increase output. Approximately 0.2-3 mm thickness of randomly oriented and/or highly-aligned fibers may be deposited onto the form, and polymer rings added, followed by an additional approximately 0.2-3.0 mm of fiber added while the form is rotated. The scaffold may placed in a vacuum overnight to ensure removal of residual solvent (typically less than 10 ppm) and treated using a radio frequency gas plasma for 1 minute to make the fibers more hydrophilic and promote cell attachment.

In accordance with this invention, an exemplary preparation of electrospinning solution typically includes of polyethylene terephthalate (PET), polycaprolactone (PCL), polylactic acid (PLA), polyglycolic acid (PGA), polyetherketoneketone (PEKK), polyurethane (PU), polycarbonate (PC), polyamide (Nylon), natural polymers such as fibronectin, collagen, gelatin, hyaluronic acid or combinations thereof that are mixed with a solvent and dissolved. A form is prepared for the deposition of nanofibers. Optionally, simulated cartilage or other supportive tissue may be applied to the form and the fibers are then sprayed onto or transferred onto a form to build up the scaffold. The present invention may be useful for the preparation of a number of bodily tissues, including hollow organs, three-dimensional structures within the body such as trachea, esophagus, intestine or luminal structures, such as nerves (epineurium or perineurium), veins and arteries (aorta, tunica externa, external elastic lamina, tunica medica, internal elastic lamina, tunica inima). Other preforms for mammals such as primates, cats, dogs, horses and cattle may be produced.

While the present invention has been illustrated by the description of exemplary embodiments thereof, and while the embodiments have been described in certain detail, it is not the intention of the Applicant to restrict or in any way limit the scope of the appended claims to such detail. Additional advantages and modifications will readily appear to those skilled in the art. Therefore, the invention in its broader aspects is not limited to any of the specific details, representative devices and methods, and/or illustrative examples shown and described. Accordingly, departures may be made from such details without departing from the spirit or scope of the applicant's general inventive concept.

For example, the present invention encompasses the following exemplary embodiments and variants thereof: (i) a composite scaffold seeded with stem cells and promoted to differentiate into stratified tissue; (ii) separate scaffold layers or sheets seeded independently to form different types of tissue and then assembled together using sutures, adhesive or welding to form a tubular shape and the stratified tissue; (iii) a scaffold implanted without cells for immediate replacement of damaged tissue and allow for cellular migration in vivo; (iv) an electrospun fiber scaffold made from non-resorbable materials such as polyethylene terephthalate, polyurethane, polycarbonate, poly ether ketone ketone; (v) an electrospun fiber scaffold made from resorbable materials such as polycaprolactone, polylactic acid, polyglycolic acid; (vi) an electrospun fiber scaffold made from natural polymers such as collagen, gelatin, fibronectin, hyaluronic acid or any combination of material types; (vii) an electrospun fiber scaffold made from a single layer of oriented fibers or a composite comprising layers of oriented fiber to correspond to the native structure and help orient and differentiate cells (fiber orientation can be from a rotating mandrel (circumferential fiber alignment), a translating mandrel (longitudinal fiber alignment), or split ground method of using electrostatics to align the fiber); (viii) using a pre-shaped mandrel or form to deposit fibers onto to achieve a near net shaped esophagus or intestine or other organs that support/perform peristalsis—the pre-shaped form can have a slight taper machined into the mandrel or coated with a non-stick surface to allow easy removal of the scaffold; and (ix) using a pre-shaped mandrel or form to deposit fibers onto to achieve a near net shaped esophagus segment/patch or intestine segment/patch or other organ segment/patch that supports/performs peristalsis. A pre-shaped form can have a slight taper machined into the mandrel or coated with a non-stick surface to allow easy removal of the scaffold. 

1. A process for manufacturing a prosthetic organ, comprising: (a) creating a preform that is based on the actual three-dimensional structure of a native mammalian organ; (b) depositing at least one layer of polymer fibers on the preform by electrospinning, wherein the at least one layer of polymer fibers includes fibers that have been deposited generally parallel relative to one another, fibers that have been deposited randomly relative to one another, or a combination thereof, and wherein depositing at least one layer of polymer fiber on the preform is operative to create a three-dimensional prosthetic organ suitable for implantation into a biological organism; (c) removing the prosthetic organ from the preform; and (d) optionally, preseeding each of the at least one layers of polymer fiber with at least one type of biological cell prior to implantation into a biological organism. 2.-10. (canceled)
 11. An implantable artificial organ scaffold comprising: at least one layer of electrospun fibers formed into a replica of a biological organ having a luminal structure, wherein the electrospun fibers have an orientation, a diameter, and a fiber spacing configured to control the orientation, growth, or differentiation of biological cells seeded thereon.
 12. The implantable artificial organ scaffold of claim 11, wherein the biological organ is one of the following: an esophagus, a small intestine, a large intestine, a duodenum, a jejunum, and a blood vessel.
 13. The implantable artificial organ scaffold of claim 11, wherein the electrospun fibers are selected from a non-resorbable material, a partially resorbable material and a combination thereof.
 14. The implantable artificial organ scaffold of claim 11, wherein the electrospun fibers comprise one or more of the following: a polyurethane, a polycarbonate, a polyester, a polycaprolactone, a polylactic acid, a polyglycolic acid, a polyetherketoneketone, a polyamide, a gelatin, a collagen, a hyaluronic acid, and a fibronectin.
 15. The implantable artificial organ scaffold of claim 11, wherein the electrospun fibers have a diameter of about 1000 nanometers or less.
 16. The implantable artificial organ scaffold of claim 11, wherein the electrospun fibers have a diameter of about 50 micrometers or less.
 17. The implantable artificial organ scaffold of claim 11, wherein the electrospun fibers have an aspect ratio selected from a round aspect ratio and a ribbon-like aspect ratio.
 18. The implantable artificial organ scaffold of claim 11, wherein the electrospun fibers have a fiber spacing of about 2 micrometers to about 50 micrometers.
 19. The implantable artificial organ scaffold of claim 11, wherein the electrospun fibers have an orientation selected from substantially mutually parallel, randomly oriented, and a combination thereof.
 20. The implantable artificial organ scaffold of claim 11, wherein the electrospun fibers comprise substantially a single material.
 21. The implantable artificial organ scaffold of claim 11, wherein the electrospun fibers comprise a mixture of multiple materials.
 22. The implantable artificial organ scaffold of claim 11, wherein the electrospun fibers comprise one or more of the following: an elutable drug, an anti-bacterial material, and a radiopaque material.
 23. The implantable artificial organ scaffold of claim 11, further comprising at least one supportive material on which the electrospun fibers may be deposited.
 24. The implantable artificial organ scaffold of claim 23, wherein the at least one supportive material comprises a simulated cartilage.
 25. The implantable artificial organ scaffold of claim 11, wherein the at least one layer of electrospun fibers comprises a plurality of layers of electrospun fibers.
 26. The implantable artificial organ scaffold of claim 25, wherein the electrospun fibers of each layer of the plurality of layers of electrospun fibers comprise a first material.
 27. The implantable artificial organ scaffold of claim 25, wherein the electrospun fibers of at least one layer of the plurality of layers of electrospun fibers comprise a first material, and the electrospun fibers of at least a second layer of the plurality of layers of electrospun fibers comprise a second material.
 28. The implantable artificial organ scaffold of claim 25, wherein the electrospun fibers of each layer of the plurality of layers of electrospun fibers have a first diameter.
 29. The implantable artificial organ scaffold of claim 25, wherein the electrospun fibers of at least one layer of the plurality of layers of electrospun fibers have a first diameter, and the electrospun fibers of at least a second layer of the plurality of layers of electrospun fibers have a second diameter.
 30. The implantable artificial organ scaffold of claim 25, wherein the electrospun fibers of each layer of the plurality of layers of electrospun fibers have a first orientation.
 31. The implantable artificial organ scaffold of claim 25, wherein the electrospun fibers of at least one layer of the plurality of layers of electrospun fibers have a first orientation, and the electrospun fibers of at least a second layer of the plurality of layers of electrospun fibers have a second orientation.
 32. The implantable artificial organ scaffold of claim 25, wherein the electrospun fibers of each layer of the plurality of layers of electrospun fibers have a first fiber spacing.
 33. The implantable artificial organ scaffold of claim 25, wherein the electrospun fibers of at least one layer of the plurality of layers of electrospun fibers have a first fiber spacing, and the electrospun fibers of at least a second layer of the plurality of layers of electrospun fibers have a second fiber spacing.
 34. The implantable artificial organ scaffold of claim 11, wherein the at least one layer of electrospun fibers comprises a plurality of electrospun fibers.
 35. The implantable artificial organ scaffold of claim 34, wherein at least one of the plurality of electrospun fibers comprises a first material, and at least a second of the plurality of electrospun fibers comprises a second material.
 36. The implantable artificial organ scaffold of claim 34, wherein at least one of the plurality of electrospun fibers has a first diameter, and at least a second of the plurality of electrospun fibers has a second diameter.
 37. An implantable artificial organ comprising: a scaffold comprising at least one layer of electrospun fibers formed into a replica of a biological organ having a luminal structure, wherein the electrospun fibers have an orientation, a diameter, and a fiber spacing configured to control the orientation, growth, or differentiation of biological cells seeded thereon; and a plurality of biological cells seeded on the scaffold.
 38. The implantable artificial organ of claim 37, wherein the plurality of biological cells comprises one or more of autologous cells and allogeneic cells.
 39. The implantable artificial organ of claim 37, wherein the plurality of biological cells comprises one or more of the following: cord blood cells, embryonic stem cells, induced pluripotent cells, mesenchymal cells, placental cells, bone marrow derived cells, hematopoietic cells, epithelial cells, endothelial cells, fibroblast cells, and chondrocyte cells.
 40. The implantable artificial organ of claim 37, wherein the at least one layer of electrospun fibers comprises a plurality of layers of electrospun fibers.
 41. The implantable artificial organ of claim 30, wherein at least a first layer of the plurality of layers of electrospun fibers is seeded with a plurality of a first type of biological cells, and at least a second layer of the plurality of layers of electrospun fibers is seeded with a plurality of a second type of biological cells.
 42. A method for fabricating an implantable artificial organ, the method comprising: depositing, by electrospinning, at least a first layer of polymer fibers onto a preform, wherein the deposited polymer fibers have an orientation, a diameter, and a fiber spacing configured to control the orientation, growth, or differentiation of biological cells seeded thereon; and removing the at least first layer of polymer fibers from the preform.
 43. The method of claim 42, wherein a shape of the preform is based at least in part on a structure of a biological organ.
 44. The method of claim 42, wherein a shape of the preform is based at least in part on a computer model.
 45. The method of claim 42, wherein electrospinning comprises: extruding a polymer solution from a fiberization tip; creating an electronic field proximate to the fiberization tip; and providing a ground or opposite polarity in the preform.
 46. The method of claim 45, wherein the preform is rotated about an axis.
 47. The method of claim 45, wherein the preform is translated in space.
 48. The method of claim 42, further comprising contacting the preform with at least one supportive material.
 49. The method of claim 42, further comprising subjecting the at least first layer of polymer fibers to at least one mechanical stress.
 50. The method of claim 42, further comprising subjecting the at least first layer of polymer fibers a plurality of cycles of an applied mechanical stress
 51. The method of claim 42, further comprising seeding the at least first layer of polymer fibers with a plurality of biological cells.
 52. The method of claim 42, wherein depositing, by electrospinning, at least a first layer of polymer fibers onto a preform, comprises depositing, by electrospinning, a plurality of layers of polymer fibers onto the preform.
 53. The method of claim 52 further comprising: seeding a plurality of a first type of biological cell onto at least a first layer of polymer fibers; and seeding a plurality of a second type of biological cell onto at least a second layer of polymer fibers.
 54. A method of implanting an artificial organ in a patient in need thereof comprising: implanting in the patient an artificial organ, wherein the artificial organ comprises at least one layer of electrospun fibers formed into a replica of a biological organ having a luminal structure, and wherein the electrospun fibers have an orientation, a diameter, and a fiber spacing configured to control the orientation, growth, or differentiation of biological cells seeded thereon.
 55. The method of claim 54, further comprising seeding the artificial organ with a plurality of biological cells. 